Hemostatic disorders: acquired

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction, Acute presentation, Pathogenesis, Etiology, Pathophysiology, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Treatment, Initial symptomatic treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Severine Tasker BSc BVSc DSAM CertSAM DipECVIM-ca MRCVS
Synonyms Bleeding disorders

Introduction

  • Signs : associated with hemorrhage - usually adult onset.
  • Treatment : symptomatic often requiring blood product administration, while addressing underlying cause.
  • Prognosis : depends on underlying cause.

Diagnosis

Clinical signs

  • Depend upon where bleeding occurs:
    • Pulmonary hemorrhage   →   dyspnea, coughing, epistaxis. Dyspnea very common as a result of intrathoracic or pulmonary hemorrhage.
    • Subcutaneous and intramuscular   →   hematomas (can be very painful).
    • Intestinal   →   hemorrhagic gastroenteritis.
    • Genitourinary   →   hematuria.
    • Cardiac   →   hemopericardium.
    • Joints    →    hemathrosis and lameness.
    • Meningeal or cerebral bleeding   →   neurological signs, seizures.
    • Petechiation and bruising particularly apparent with platelet disorders.
Other signs
  • Anemia (apparent only after few hours of acute bleed).
  • Collapse.
  • Hypothermia.

Sequelae

Prognosis

  • Guarded: if severe case. Depends on site and underlying cause and control of hemorrhage.

Expected response to treatment

  • Normalization of clotting times or platelet count.
  • Color returns to mucous membranes.
  • Patient becomes more alert/responsive.
  • Resorption hematoma/hemorrhages.

Reasons for treatment failure

  • Non-detection of hemorrhage, eg internal.
  • Delay in treatment of underlying cause.
  • Inadequate supportive therapy (plasma or blood).

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Bianco D, Armstrong P J & Washabau R J (2008)Presumed primary immune-mediated thrombocytopenia in four cats.J Feline Med Surg10, 495-500PubMed.
  • Brazzell J L & Borjesson D L (2007)Evaluation of plasma antithrombin activity and D-dimer concentration in populations of healthy cats, clinically ill cats, and cats with cardiomyopathy.Vet Clin Pathol36, 79-84PubMed.
  • Estrin M A, Wehausen C E, Jessen C R & Lee J A (2006)Disseminated intravascular coagulation in cats.JVIM20, 1334-1339PubMed.
  • Kohn B, Linden T & Leibold W (2006)Platelet-bound antibodies detected by a flow cytometric assay in cats with thrombocytopenia.J Feline Med Surg8, 254-260PubMed.
  • Smith W, Day T & Mackin A (2005)Diagnosing Bleeding Disorders.Compen Contin Educ Pract Vet27, 828-843.
  • Kohn B, Weingart C & Giger U (2003)Haemorrhage in seven cats with suspected anticoagulant rodenticide intoxication.J Feline Med Surg5, 295-304PubMed.
  • Center S A, Warner K, Corbett J, Randolph J F & Erb H N (2000)Proteins invoked by vitamin K absence and clotting times in clinically ill cats.JVIM14, 292-297PubMed.
  • Randolph J Fet al(2000)Prothrombin, activated partial thromboplastin, and proteins induced by vitamin K absence or antagonists clotting times in 20 hyperthyroid cats before and after methimazole treatment.JVIM14, 56-59PubMed.
  • Tasker S, Mackin A J & Day M J (1999)Primary immune-mediated thrombocytopenia in a cat.JSAP40, 127-131PubMed.
  • Tasker S, Cripps P J & Mackin A J (1999)Estimation of platelet counts on feline blood smears.Vet Clin Pathol28, 42-45.
  • Lisciandro S C, Hohenhaus A & Brooks M (1998)Coagulation abnormalities in 22 cats with naturally occurring liver disease.JVIM12, 71-75.
  • Hart S W & Nolte I (1994)Hemostatic disorders in feline immunodeficiency virus-seropositive cats.JVIM8, 355-362PubMed.

Other sources of information

  • Stokol T (2005)Disorders of haemostasis.In: E Villiers & Blackwood L (eds)BSAVA Manual of Canine and Feline Clinical Pathology.2nd edn, BSAVA, Gloucester. pp 83-98.

Sample content only, to unlock the full article login or buy now

Loading...